tools to assess community capacity buildingsharepoint.dmcportal.org/emrdeployment/cirtguide...3 1....

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Tools to Assess Community Capacity Building:

For Use in Evaluating Community Initiatives

- Final -

Submitted to AOHC

December 10, 2008

Bronwyn Underhill

[email protected]

Suzanne Jackson

[email protected]

Revised June 18, 2009

mailto:[email protected]

mailto:[email protected]

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Table of Contents

1. Background to tools ________________________________________________ 3

2. Conceptual Framework for the tool __________________________________ 5

3. Description of the evaluation tools___________________________________ 7

4. Using the tools _____________________________________________________ 9

5. Assessment Tool __________________________________________________ 12

6. Context tool _______________________________________________________ 38

7. Monitoring tool ____________________________________________________ 46

8. End-of-CI tool _____________________________________________________ 48

9. Glossary of Terms _________________________________________________ 55

References ___________________________________________________________ 56

Appendix: Literature review - Conceptualizing the Domains of Community Capacity ____________________________________________________________ 57

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1. Background to tools

This document describes a series of tools to assess community capacity building

for the purposes of evaluating community initiatives (CIs) in Ontario’s

Community Health Centres. Community initiatives are defined as:

“sets of activities aimed to strengthen community capacity to address

factors affecting collective health 1”

As community capacity building is central to community initiatives, this tool

uses community capacity as the basis for CI evaluation. Community capacity is:

“(1) the characteristics of communities that affect their ability to identify,

mobilize, and address social and public health problems' [and]

(2) the cultivation and use of transferable knowledge, skills, systems, and

resources that affect community- and individual-level changes consistent

with public health-related goals and objectives.2”

This tool was prepared using new and state-of-the-art literature regarding

community capacity and evaluations of community programming. This project is

not an in-depth literature review: this tool is “literature-informed.” Those

searching for an in-depth analysis of the theory of community programming are

encouraged to read Kwan et al. (2003)3 and Rajkumar (1997) 4.

From this literature-informed work, community capacity was broken down into

11 domains, with 29 selected indicators grouped under 4 main action areas (see

table 1). For the purposes of creating a tool that could be readily used by

practitioners, only the most relevant indicators were included in the main list.

Therefore, this grouping of domains and indicators should be seen as a base,

from which health centres are encouraged to add specific areas for measurement

as deemed relevant to their work. Additionally, different CHCs may wish to

prioritize selected indicators, or measure them in greater detail in order to

facilitate evaluation of particular CIs.

Evaluating and assessing progress in community-based work is a complex

process. This tool is based on the most recent research and literature in this field,

and on existing tools that have been widely used across Canada. This being the

case, the user should feel confident that they are using a tool that is well-

supported by evidence. AOHC and the Ontario CHCs have the potential to be

trail-blazers in this work. It is hoped that the tool will facilitate planning and

evaluation of CIs, as well as support the development of a collective body of

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knowledge from these projects that can be used to support practitioners in their

work.

NB: It is planned that these tools would be translated into electronic form in

order to facilitate easy use by CHC staff.

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2. Conceptual Framework for the tool

The tools are based on a conceptual framework for understanding community capacity building. This framework was developed

based on the most recent national and international literature in the area (see Appendix), and is presented in the table, below. There

are four “essential elements” that are necessary for effective community capacity building. These elements comprise a total of 11

domains. Indicators are then presented for each domain.

It is this understanding of community capacity building that informs the development of the tools presented in this paper.

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Essential elements Domains Selected Indicators

Enabling community leadership Participation A broad range of community organizations and populations are involved 2, 5

Barriers to participation have been overcome 2, 5, 6

Multiple opportunities for participation exist 3, 6

Leadership Roles and responsibilities of leaders are defined 2, 5

(New) community leaders become progressively more involved 2, 5, 6

Conflict resolution mechanisms are in place 6

Community control The community influences the project in all phases 2

Community members have formal representation in the project 3, 7, 8

Fostering community identity Diversity and

equity

Events are accessible to a range of populations, including vulnerable groups 7, 9

Leadership and other roles are represented by a diverse group 7

Sense of

community and

identity

Members have a sense of community and pride, including celebrations 2, 3, 5-8

Members have concern for, and take action on, community-level issues 2, 3, 6, 8

The community has defined norms, values, attributes 2, 6

Developing skills and resources Skills, learning, and

knowledge

Relevant needs and strengths have been identified 5 6

Learning and training opportunities are present within the community 3, 5, 6

Resources The CI has access to internal resources 2, 5-7

The CI has access to external resources 2, 5-8

Resources are pooled and shared equitably 2, 3, 5, 6, 8

Reflection The community is involved in exploring root causes and searching for solutions 2, 5

The CI addresses some of the root causes of issues 5

Agency staff reflect on CI efforts 2

Building and utilizing structures

and relationships

Community and

internal structures

Areas for CHC support in community have been identified and developed 3, 5, 7

Community structures have strong relationships and communication 3, 6, 7

Community agencies have articulated their values and priorities 6, 8

External supports

and community

relations

External agencies have supportive policies and plans 3, 5, 7

There are positive external perceptions of the community 7

There are positive community perceptions of the agency 3

Linkages Community structures and CHCs have strong current/historical links 3, 5-8

Diverse sectors (like-minded and dissimilar) network and work collaboratively 2, 5, 8

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3. Description of the evaluation tools

In this paper we present a total of four tools. It is intended that these tools be

used together to support planning, on-going monitoring, and final evaluation of

CIs. Practitioners are encouraged to use the Assessment Tool as a way to

stimulate discussion with community members, particularly members of the

leadership group, to ensure that the evaluation reflects community impressions

and that action plans are developed jointly with the community. Management

may also be involved in order to ensure that the CI is understood and

coordinated with other areas of activity of the CHC.

3.1 Assessment Tool:

The purpose of the Assessment Tool is to take a “snapshot” of the factors that

contribute to community capacity at a given point in time. The Assessment Tool

is based on the work of PHAC5 and uses a “journey” metaphor to describe

progress related to community capacity. The tool is organized by domains and

corresponding indicators in the order they appear in Table 1.

For each indicator, practitioners, community leaders, and/or management are

encouraged to discuss the statements under “just started”, “on the road”, “nearly

there”, and “we’re there” and indicate the statement that best applies to the CI at

that point. If desired, those filling in the tool can add a note to provide further

explanation or context. If the CI has already reached the “we’re there” stage,

those completing the tool should reflect on whether or not they have done

additional relevant work. If so, they should check off the “what’s next” box and

add a brief description of the action. From “just started” to “we’re there”, results

can be quantified and analyzed accordingly (e.g. with bar graphs, on scales).

Additionally, for each indicator, those filling out the tool can list the main

relevant enablers and/or barriers that they face.

There are two important considerations to note with respect to assigning a rating

to each indicator:

Although the ratings are based on a “journey” metaphor, the journey

rarely follows a straight line from origin to destination. In reality, there

can be many deviations along the way, for example, due to the fact that

key community leaders might leave the project due to some unavoidable

circumstance. Therefore, the practitioners and community leaders who

assign the ratings should not “judge” a decrease in a rating as being

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necessarily negative; it should be reported as part of the evolution of the

CI and strategies modified appropriately.

In reality, the journey of building community capacity is more often

cyclical than linear. The completion of one stage is usually the start of the

next. This should be taken into account when completing the form.

At the end of each domain section (e.g. participation, leadership), those filling

out the tool have the opportunity to:

“tell the story” (note main factors relevant to progress on that domain),

list “best practices or key learnings” (any relevant information they feel

should be shared within the CHC and among CHCs in order to improve

CIs)

jot down an action plan, given their current state.

Qualitative data is just as important as quantitative data as practitioners have

expressed a desire for qualitative data collection that “tells the story” of their

project and helps to capture lessons learned from the experience.

3.2 Context tool:

The context tool provides information to plan the CI and analyze the context in

which the CI will operate. This tool – based on current information gathered for

CIs – is mainly quantitative and relatively easy to fill out. The information

gathered may be updated as necessary, but should primarily be used for

preliminary planning. This information will also be collected on an AOHC

database of CIs which will be searchable by CHC staff.

3.3 Monitoring tool:

The monitoring tool provides the opportunity to update the type of information

collected with the context tool, as well as noting the resources expended on the

CI (time, supplies, etc. that might be relevant), as well as progress on other

indicators of interest over the monitoring period. As well, any major

achievements to date and programming spin-offs should be noted here.

3.4 End-of-CI tool:

At the end of the CI, this tool should be used to provide a final account of the

information collected with the context and monitoring tool, as well as an overall

impression of the journey of the CI.

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4. Using the tools

4.1 When to use the tools

It is envisioned that the tool will be used at three stages of the CI:

Start of CI:

o Use Assessment Tool and Context Tool with community and staff

(preferably) for a starting point and to look for areas to develop.

o Questions: “Under what conditions is the initiative operating?”; “What

barriers or enablers can we anticipate for this CI?”; “Where should we

focus our work?”

Ongoing Progress:

o Use Assessment Tool and Monitoring Tool with staff, community,

and management for ongoing monitoring, some stories and key

learnings, a reflection on the current path, and any changes needed

o Monitoring may take place monthly among CHC staff, every 3-4

months with community involvement as well.

o Annual or bi-annual evaluations should also include management.

o Question: “What is our progress to date?”

End of CI:

o Use Assessment Tool and End-of-CI Tool at the end of project to

reflect on overall trends, learnings, and next steps

o Will ideally be done with staff, community, and management

o Questions: “What did the CI accomplish?”; “How did it evolve or

develop over the life of the CI?”; “What did we learn from this

experience?”

The use of the tools is summarized in the following table.

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Use of CI Community Capacity Tools

Stage of CI Which Tool to

Use?

Purpose Key Questions to be

addressed

Start Context Tool Provides general background

on project (which can be

placed on an AOHC database

to be accessible by other

CHCs). Should be updated

only as required.

Who is doing this CI?

What is this CI all

about?

Assessment

Tool

To take an initial “snapshot”

of the various indicators of

community capacity at start of

project.

What barriers or

enablers can we

anticipate for this CI?

Where should we

focus our work?

Ongoing

progress

(every 3-4

months)

Assessment

Tool

To take regular “snapshots” to

assess changes in indicators of

capacity building.

Where have we made

progress in capacity

building?

Where do we need to

focus?

Monitoring

Tool

To document key activities,

accomplishments, stories and

learnings throughout the CI.

Anecdotal format.

What has happened?

What can we learn

from this?

End of CI Assessment

Tool

To take a final “snapshot” to

assess changes in indicators of

capacity building over the life

of the CI.

To summarize learnings in

process of doing capacity

building

Where have we made

progress in capacity

building?

What did we learn

about capacity

building?

End-of-CI Tool To summarize

accomplishments made over

the life of the CI.

The combination of the final

Assessment Tool report and

the End-of-CI Tool report

summarizes the evaluation

and learnings of the CI. A

summary of any additional

evaluations of the CI (e.g. on

areas other than capacity

building) can be attached to

the End-of-CI Tool.

What was

accomplished through

this CI?

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4.2 How to use the tools

Guidance

The tool is set up along the following lines

o Main areas for action

Specific domains

Selected indicators

For each indicator, check off what statement best describes the current state

of the CI using the “journey” metaphor

Add description/commentary if helpful or relevant

NB: “what’s next” is not a prescriptive section, but rather gives a potential

example of continuing processes in a given indicator once a CI has reached

the “we’re there” stage. You may add a comment or example of what is in

your “what’s next” section.

Add description of main enablers/barriers, if desired

Continue on to the next indicator

At the end of each domain:

o Note the “story” of progressing on that domain

o Note the key learnings/best practices related to that domain

o Jot down ideas for an action plan related to that domain

NB: all qualitative information should be added based on the perceived

relevance by program staff

Move on to the next domain and its corresponding indicators

Assessment Tool

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5. Assessment Tool

Enabling community leadership:

Community leadership is fostered by participation and participation necessitates and builds good leadership

abilities both formally and informally. Participation should be a process by which a community is able to better

influence and determine the processes which shape its health and well-being and, as such, is a critical component

of community control.

Participation:

Participation occurs when multiple stakeholders are meaningfully engaged in various components of projects and

programs, including decision-making and evaluation 5, 6, 9. Participation can be measured on a scale, from

consultation to community control 10: different levels of participation are best suited to specific programming

objectives.

Leadership:

Strong levels of participation can build community leadership and foster community control over a program

(particularly necessary for programming sustainability). Leadership includes both the formal and informal roles of

those community members who act to provide direction and vision, engage with others, and enhance project

capacity.

Community control:

Community control is in line with Gibbon, Labonte, and Laverack’s (2002) vision of empowerment that:

“presumes that the identification of problems, solutions to the problems and actions to resolve the problems are

carried out by the community.” Community control is a central tenet of community capacity, particularly when

projects can be sustained or designed by communities themselves.

Assessment Tool

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Enabling Community Leadership: Participation

1. Involving a broad range of community organizations and members

(For example, involvement from different ages, from various community groups)

Just started 1 On the road 2 Nearly there 3 We’re there 4 What’s next

We have not yet

identified who to

involve

We have identified the

range of who should be

involved

We have contacted

appropriate representatives

A range of populations and

community organizations

are involved

e.g. identifying new

partners, keeping track of

membership

Describe:

2. Overcoming barriers to participation

(For example ,barriers related to finances, accessibility, discrimination, timing, language, cultural norms, gender, literacy, information)


We have not yet

identified potential

barriers to participation

We are identifying

potential barriers to

participation

We are addressing barriers

to participation with

community feedback

Our work in overcoming

barriers has increased

participation

e.g. continually reflecting on

new barriers, and identifying

facilitating factors

Describe:

Enablers Barriers

Enablers Barriers

Assessment Tool

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3. Multiple opportunities for participation

(For example, participation at meetings, in project planning, implementation, evaluation; participating from home, with smaller or larger

groups)


We have not yet

identified all potential

venues for participation

We have ideas for diverse

opportunities but are not

sure how to proceed

Some diverse opportunities

exist, but we are still in the

process of expanding more

There are multiple

participation opportunities

in place in the program

e.g. As project grows, so too

do opportunities for

involvement

Describe:

Participation overall:

Enablers Barriers

Telling the story of participation

Key learnings/best practice regarding participation

Action plan regarding participation

Assessment Tool

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Enabling Community Leadership: Leadership

1. Roles and responsibilities of leaders

(For example, community and agency expectations of community leaders, leaders’ expectations of themselves; developing accountability and

reporting guidelines)


Roles/responsibilities of

community leaders have

not been defined

We are defining leadership

roles and responsibility

with the community

We have defined key roles

and responsibilities of

leaders

Key roles/responsibilities

are finalized and leaders act

accordingly

e.g. Redefining roles and

responsibilities as project

advances

Describe:

2. (New) community leaders become progressively more involved

(For example, developing leadership with people who normally don’t fill those roles; working with both informal and formal leaders)


We have not yet

identified potential new

community leaders

We are in the process of

identifying potential new

community leaders

We have identified new

leaders and are developing

ways to support them

New community members

have become involved since

the inception of the CI

e.g. mentoring processes,

recognizing formal and

informal leadership roles

Describe:

Enablers Barriers

Enablers Barriers

Assessment Tool

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3. Conflict resolution mechanisms

(For example, collaboration, negotiation, mediation, arbitration)


We have not yet thought

about conflict resolution

mechanisms


developing conflict

resolution mechanisms

Guidelines are in place

regarding conflict

resolution in the CI

Conflict is effectively

resolved using the

mechanisms in place

e.g. monitoring use of

mechanisms, learning from

conflict situations

Describe:

Leadership overall:

Enablers Barriers

Telling the story of leadership

Key learnings/best practice regarding leadership

Action plan regarding leadership

Assessment Tool

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Enabling Community Leadership: Community Control

1. Community influence on project throughout different phases

(For example, during project planning, implementation, and evaluation; with decision-making responsibilities)


The community is not

yet involved in all stages

of the program


identifying avenues of

community involvement

Community members are

becoming involved in all

phases of the program

The community is involved

in and influences all phases

of programming

e.g. a new or expanded

program plan due to

community involvement

Describe:

2. Formal representation of community members

(For example, as board members, as signatory bodies for funding)


There is not yet any

formal involvement of

community members

We have identified areas

for formal community

involvement

There are areas for formal

involvement, but

community is not involved

Community members are

actively participating in

formal representation areas

e.g. looking at diversity of

formal representation, post-

involvement activities

Describe:

Enablers Barriers

Enablers Barriers

Assessment Tool

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Community control overall:

Telling the story of community control

Key learnings/best practice regarding community control

Action plan regarding community control

Assessment Tool

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Fostering community identity:

Community identity is essential in community based programs in terms of determining who is/isn’t involved and

how members conceptualize their membership and their place within the community. Additionally, community

identity can influence who does or doesn’t participate and in what capacity.

Diversity and equity:

Communities are diverse and, as everywhere, inequities are real and present. Diversity may encompass gender,

ethnicity, age, educational background, socio-economic status, and sexual orientation, among many other areas.

Equity recognizes that some groups or individuals have more and others have less, and that these disparities are

unfair, unjustified, and should be remedied.

Sense of community and identity:

A sense of community is characterized by members feeling connected to each other and the space they inhabit,

overall levels of respect and concern for each other and for larger issues affecting the community, and a positive

perception of the community 2, 6-8.

Assessment Tool

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Fostering Community Identity: Diversity and Equity

1. Identified vulnerable groups’ involvement in events

(For example, identifying and actively engaging marginalized populations based on –e.g.- ethnicity, socio-economic status, gender, etc.)


We have not yet

identified vulnerable or

marginalized groups

We have identified groups

but do not have plans for

accessibility or involvement

We have plans in place to

increase involvement of

marginalized groups

Vulnerable groups are

actively involved in CI

events and activities

e.g. examining how

involvement affects

vulnerability of populations

Describe:

2. Representation of a diverse population in leadership

(For example, diversity in ethnicity, gender, age, socio-economic group, etc.)


Community roles and

responsibilities are not

reflective of CI diversity

We have plans to increase

diverse representation in

leadership positions

Diversity in leadership

representation is increasing

Diverse groups are

represented in leadership

and other roles

e.g. examining how this

diversity affects

programming

Describe:

Enablers Barriers

Enablers Barriers

Assessment Tool

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Diversity and equity overall:

Telling the story of diversity and equity

Key learnings/best practice regarding diversity and equity

Action plan regarding diversity and equity

Assessment Tool

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Fostering Community Identity: Sense of Community and Identity

1. Sense of community and pride

(For example, community perceptions of pride, community involvement in celebrations)



about how CI can benefit

community identity

We are not sure how to

proceed with building

community identity

We have incorporated

identity-strengthening

activities into the CI

CI has helped increase a

sense of community and

pride

e.g. extending messages of

community identity

externally

Describe:

2. Concern for, and action on, community-level issues

(For example, overall concerns and/or issues which may not affect all community members, but which affect a specific population; historic or

current issues which affect present-day outcomes (housing developments, environmental contamination, etc.))


Members do not yet

express concern for

community-level issues

Members express concern

for community-level issues

but have not taken action

CI staff is assisting in action

related to community-level

concerns

Members are acting on

community-wide concerns

e.g. continued identification

of emerging issues

Describe:

Enablers Barriers

Enablers Barriers

Assessment Tool

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3. Community norms, values, attributes

(For example, reciprocity, sharing, open communication, environmental protection)


The community does not

yet have defined norms

or values

Project staff is aware of the

importance of community

norms and values

Project staff actively assists

the community in defining

norms and values

Community has defined

group norms and values

e.g. on-going discussions

around norms and values,

reflection on their role in CIs

Describe:

Sense of community and identity overall:

Enablers Barriers

Telling the story of sense of community and identity

Key learnings/best practice regarding sense of community and identity

Action plan regarding sense of community and identity

Assessment Tool

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Developing skills and resources:

Community capacity is often defined in terms of its characteristics, such as increased skills of community

members, stronger linkages within and without community, and increased access to community and external

resources.

Skills, knowledge and learning:

Skills, talents, and abilities in place in a given community are present on both the individual (e.g. the ability to

chair a meeting) and community level (e.g. ability to work together and resolve conflict) 2, 7. As starting points,

goals, and facilitating factors, these form the bedrock of community capacity building 7, 11.

Resources:

Resources for community capacity include time, funding, personnel and/or volunteer support, information, and

facilities. The ability of a community to mobilize these resources is a key factor in long-term community success 12.

Necessary and valuable resources exist both within and outside of communities 2, 8, 9, 11. Increasing resources does

not necessarily lead to increased community capacity, but it is an enabling factor, as it creates the space and

opportunities for participation and involvement from diverse groups.

Reflection:

Reflection is both a skill and a resource as a process that should help communities uncover the root causes of issues

they face and plan for action accordingly. Given that many of the upstream determinants of community health are

rooted in external and internal structures (including barriers to access, discrimination, inequity, education

opportunities, etc)7, there are implicit connections between reflection and all domains of community capacity.

Assessment Tool

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Developing Skills and Resources: Skills, Learning, and Knowledge

1. Identification of needs and strengths

(For example, current assets to build upon and noted areas for improvement)


We have not yet

identified community

needs and strengths

We have a plan to identify

community needs and

strengths

We are working with

community to identify

needs and strengths

With the community, we

have identified relevant

needs and strengths

e.g. using identified

needs/strengths in planning

Describe:

2. Learning and training opportunities

(For example, skill-building exercises, peer-to-peer or agency-to-agency information dissemination)


We have not yet

provided learning

opportunities in the CI

We have identified learning

/training opportunities for

the CI

We are providing learning

and training opportunities

in the community

Learning and training

opportunities are being

accessed by the community

e.g. looking at outcomes of

training, evaluating specific

opportunities

Describe:

Enablers Barriers

Enablers Barriers

Assessment Tool

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Skills, learning, and knowledge overall:

Telling the story of skills, learning, and knowledge

Key learnings/best practice regarding skills, learning, and knowledge

Action plan regarding skills, learning , and knowledge

Assessment Tool

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Developing Skills and Resources: Resources

1. Access to internal resources

(For example, volunteers, space to meet, community members’ skills and experience)


We have not yet

identified community-

level resources

We have identified what

resources exist within the

community

We have started contacting

community in order to

access needed resources

We access the resources we

need from within the

community

e.g. examining strain on the

community caused by

accessing resources

Describe:

2. Access to external resources

(For example, materials, childcare, funding, staff knowledge and experience)


We have not yet

identified relevant

external resources

We have identified what

resources exist outside of

the community

We have started contacting

sources for relevant

external resources

We access the resources we

need from outside of the

community

e.g. awareness of other

resource areas/sources that

may be accessed

Describe:

Enablers Barriers

Enablers Barriers

Assessment Tool

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3. Pooling and sharing of resources and supports

(For example, with project partners and members: ensuring those most in need of resources have priority in accessing those resources;

addressing gaps in resource availability)



about how to best pool

and share resources

We have a plan in place to

equitably pool and share

resources

We are sharing and pooling

some resources

We are pooling and sharing

resources equitably across

partners and community

e.g. examining how resource

distribution influences other

indicators of equity

Describe:

Resources overall:

Enablers Barriers

Telling the story of resources

Key learnings/best practice regarding resources

Action plan regarding resources

Assessment Tool

29

Developing Skills and Resources: Reflection

1. Community involvement in “asking why”

(For example, exploring root causes of issues and searching for solutions)


We have not yet begun

the process of “asking

why” with community

We have a plan in place for

“asking why” with

community

We engage the community

in “asking why” and

searching for solutions

Root causes of issues are

explored and solutions are

proposed by community

e.g. working with the

outcomes of “asking why”,

incorporating solutions

Describe:

2. Addressing root causes through CI

(For example, working on the larger issues that influence original CI issue)



about root causes of the

issue addressed by CI

We are considering root

causes and how they might

affect the project

We have examined root

causes and incorporate our

insights into programming

The CI addresses some of

the root causes of issues

e.g. linking with others who

address these root causes

Describe:

Enablers Barriers

Enablers Barriers

Assessment Tool

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3. Reflection in agency staff

(For example, in meetings, personally, via evaluation processes)



about how to encourage

reflection within staff


implementing reflection

into staff time and training

We encourage reflection on

CIs and provide them with

time and resources

Staff reflects on CI efforts

and acts on those

reflections

e.g. noting any community

responses to staff reflections

Describe:

Reflection overall:

Enablers Barriers

Telling the story of reflection

Key learnings/best practice regarding reflection

Action plan regarding reflection

Assessment Tool

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Building and utilizing structures and relationships:

Strong structures and relationships within and between community and external organizations provide the necessary

foundations for community capacity through linkages and access to resources. The values and principles of

programming and staff influence the processes and outcomes of community initiatives.

Community and internal structures:

Just as there are previously existing skills, abilities, and talents within communities, there are also structures such as

organizations, networks, and groups 11, 12. These structures and relations can both enable and hinder community

capacity 7. Strong structures and enabling internal relations ensure that a diverse range of voices are heard and acted

upon, affecting participation 6, 9.

External supports and community relations:

External agents include funders, agencies, and health centres external to the community as well as policies and

perceptions 7. Outside agents have a strong role to play in fostering community capacity by challenging external barriers

to development such as detrimental policy and negative perceptions within other external agencies 7. These

organizations may also provide communities with resources or links to appropriate sources for collaborative action 11, 12.

A strong relationship between community and external agents is critical to long-term sustainability in capacity building,

as learnings can be shared across communities and agencies 8.

Linkages:

Linkages and collaboration with other agencies, communities, networks, organizations, or individuals are considered

essential for strong community capacity 11. These connections foster access to a range of resources 2, 8, 11, increase

opportunities for collective learning action across sectors and groups 9, 11, and can increase representation and

participation of diverse groups 8, 11. Networks also bring complementary skills together, creating a whole that is greater

than the sum of its parts 2, 9.

Assessment Tool

32

Building and Utilizing Structures and Relationships: Community and Internal Structures

1. Areas for CHC support of community

(For example, health information, funding, linkages with other agencies)


We have not yet

identified areas for CI

support

We have identified areas

where we can support

community structures

We are working on

supporting community

structures

As a result of our efforts,

community structures are

well supported

e.g. sustaining supports,

building ability for

community to support itself

Describe:

2. Relationships and communication among community structures

(For example, between and among community groups, agencies, councils, membership organizations)



about internal

community relationships

We are investigating

internal community

relationships

Our programming

addressed how to improve


As a result of CI,


are strengthened

e.g. examining effects of

stronger relationships among


Describe:

Enablers Barriers

Enablers Barriers

Assessment Tool

33

3. Values and priorities of community agencies

(For example, guiding principles, historic or current projects of community agencies)


We are not aware of the

values and priorities of

community groups

We have communicated

with community structures

re: values/priorities

We work with community

structures to articulate

values and priorities

CI has assisted community

structures to articulate their

values and priorities

e.g. examining how values

and priorities of structures fit

with those of members

Describe:

Community and internal structures overall:

Enablers Barriers

Telling the story of community and internal structures

Key learnings/best practice regarding community and internal structures

Action plan regarding community and internal structures

Assessment Tool

34

Building and Utilizing Structures and Relationships: External Supports and Community Relations

1. Supportive external policies/plans

(For example, within agency/partners/government; policies which influence community capacity directly or indirectly)


Current policies do not

support the actions of

the CI

We have identified the

need for policy change to

support CI and community

Policies are being

developed that support CIs

and community

Current policies support

the CI and community

e.g. monitoring adherence,

Describe:

2. External perceptions of community

(For example, via the media)


We have not identified

the external perceptions

of the community

Identified perceptions have

not yet been incorporated

into CI planning


external perceptions into CI

planning

The CI has led to improved

external perceptions of the

community

e.g. monitoring perceptions,

publicizing

community/external “image”

Describe:

Enablers Barriers

Enablers Barriers

Assessment Tool

35

3. Community perceptions of agency

(For example, members’ attitudes about previous programs)


We have not yet

identified community

perceptions of agency

Identified perceptions have

not yet been incorporated

into CI planning


community perceptions

into CI planning

The CI has led to improved

community perceptions of

the agency

e.g. building upon trust and

relationship with new

communities

Describe:

External supports and community relations overall:

Enablers Barriers

Telling the story of external supports and community relations

Key learnings/best practice regarding external supports and community relations

Action plan regarding external supports and community relations

Assessment Tool

36

Building and Utilizing Structures and Relationships: Linkages

1. Linkages between community structures and CHC

(For example, present-day and historical connections; linkages via programs, advocacy, other CIs)


We are not yet aware of


operating in the CI area

We have identified actors

and structures within the

community

We are in contact with

community groups and

structure

We have strong

connections with


e.g. working on long-term

sustainability of connections

Describe:

2. On-going networking and collaboration

(For example, between dissimilar and like-minded agencies; between government, NGOs, community-based organizations)


We don’t yet know who

we could network with

to support CI

We know which

organizations could

support CI

We are communicating

with relevant groups to

support CI

There is a broad network of

groups that are

collaborating to support CI

e.g. maintaining contact and

communications, bringing in

new partners

Describe:

Enablers Barriers

Enablers Barriers

Assessment Tool

37

Linkages overall:

Telling the story of linkages

Key learnings/best practice regarding linkages

Action plan regarding linkages

Context Tool

38

6. Context tool

This is to collect additional information for the start of each CI: based on AOHC (2007) 13

NB: Complete the assessment tool, with an eye to current state of indicators, anticipated barriers and enabling

factors, and the story of why the CI has been started.

1. Name of person completing report

2. Contact info: e-mail and phone

3. Originating CHC

4. Name of Community Initiative

5. Planned start and end dates of CI (if known)

6. What are the broad objectives of your CI? (Check as many as appropriate)

Reduce isolation, increase sense of connectedness, and strengthen social relationships/networks/cohesion

Reduce fear and improve security/safety

Increase trust/understanding

Increase community dialogue/interaction

Increase community participation

Improve living conditions (indoor)

Improve community environment (outdoor)

Improve work/school/other institutional environment

Improve recreational environment

Provide new services/facilities (to meet gaps)

Improve services/better access

Improve delivery systems (ways of doing things)

Improve communication with community (services, resource, facilities)

Create healthier organizational structures/practices

Improve health-supportive policies/policy-making processes

Increase community skills, knowledge, awareness

Context Tool

39

Increase leadership skills/capabilities

Increase capacity for collective action

Identify and mobilize community resources

Increase community influence over health/social issues

Increase community self-reliance

Other (specify):_______________________________________________

7. What are the specific objectives of your CI? (list up to 5)

8. What are the social determinants of health that this CI is intending to address? (Check as many as appropriate)

Healthy child development

Education

Employment and working conditions

Food security

Health care services

Housing

Income

Social support

Social safety nets and social services

Social justice, equity, human rights

Peace

Stable eco-system, healthy local environment

Other (specify):__________________________________________

9. What are the health promotion strategies that you plan to use/employ? (Check as many as appropriate)

Build healthy public policy

Create supportive environments

Strengthen community actions

Develop personal skills

Reorient health services

Other (specify): __________________________________________

10. What are the specific planned activities you are intending to carry out in this CI?

Context Tool

40

11. Briefly describe the origin of this CI

12. To what extent did this CI evolve from a personal development group, another CI, or any other work in the CHC. If applicable,

please list name:

13. What communities/neighbourhoods is this CI intended to serve?

Context Tool

41

14. Please specify age group(s) of the intended population for this CI: (Check as many as appropriate)

Age is not a specific characteristic of this CI

0-4 years

5-9

10-14

15-19

20-24

25-29

30-34

35-39

40-44

45-49

50-54

55-59

60-64

65-69

70-74

75-79

80-84

85-89

90+

15. Please select gender of intended population

Gender is not a specific characteristic of this CI

Male

Female

Transgender/transsexual/inter-sexed/questioning

16. Please select primary language(s)/culture(s) of intended population. (Check as many as appropriate)

Language/culture is not a specific characteristic of this CI

English

French

Arabic

Chinese – Cantonese

Context Tool

42

Chinese – Mandarin

Chinese – Hakka

Chinese – (other)

Cree

Dutch

German

Greek

Hindi

Inuktitut

Italian

Polish

Portuguese

Punjabi

Russian

Somali

Spanish

Tagalog (Philipino)

Tamil

Ukranian

Vietnamese

Other (specify):___________________________________

17. Please select primary description(s) of the role/status/identity of intended population: (Check as many as appropriate)

Role/status/identity is not a specific characteristic of this CI

Business people

Caregivers

Community leaders

Community members

Community volunteers

Criminal offenders

Employees

Employers

Family members

Gays/lesbians

Context Tool

43

Health providers

Immigrants

Newcomers

Refugees

Parents

Expectant parents

New parents

Single parents

Persons without a health card

Students

Seniors

Frail elderly

Youth

Children

Other (specify): ___________________________________________

18. Please select social/economic conditions addressed by CI: (Check as many as appropriate)

Social/economic condition is not a specific characteristic of this CI

Environmental pollution

Environmental degradation

Homelessness

Inadequate housing

Inadequate transportation

Language/cultural barrier

Low-income/poverty

Low literacy

Occupational/workplace risks

Racism/discrimination

Social isolation

Underemployment

Unemployment

Violence/abuse

Victims of violence/abuse

Witnesses of violence/abuse

Context Tool

44

Perpetrators of violence/abuse

Other (specify): ____________________________________________

19. Please select health condition(s) addressed by CI. : (Check as many as appropriate)

Health conditions are not a specific characteristic of this CI

Arthritis

Asthma

Diabetes

Hypertension

Heart Disease

HIV/AIDS

STIs

Physical disability

Physical frailty

Obesity

Eating disorder

Chronic pain

Physical fitness

Nutrition

Sexual health

Substance use/addictions

Alcohol

Tobacco

Drugs/medication

Dental health

Mental health

Schizophrenia

Depression

Trauma

Other (specify):__________________________________________

20. Please describe CI partners and roles, if relevant

Context Tool

45

21. Please list names of CI partners.

Monitoring Tool

46

7. Monitoring tool

Additional information for on-going evaluations NB: Complete the monitoring tool with an eye to current barriers/enablers, current action plan, current learnings, and current stories


2. Date of monitoring (from last evaluation to current evaluation)

3. Brief description of activities used since last evaluation

4. Population involved in CI since last evaluation

5. Partners involved in CI since last evaluation

6. Staff time on CI since last evaluation

7. Resources expended on CI since last evaluation (description and value)

8. In-kind resources used since last evaluation (e.g. volunteer hours, donated space)

9. Main achievements to date

10. Report on specific indicators (these could be any other indicators that the participants and the CHC wish to track).

11. Key observations or stories

12. Has the CI led to “spin-off” activities? (e.g. personal development group, increased attendance at health clinic). Please list activities, if

relevant.

Monitoring Tool

47

13. Attach meeting notes, minutes or reports, if necessary.

End-of-CI Tool

48

8. End-of-CI tool

Additional information to be collected for end-of-CI

NB: Complete the End-of-CI tool with an eye to current status of indicators, life-of-CI major barriers/enablers faced, life-of-

CI learnings, and life-of-CI stories to tell.

The important elements to focus on are changes that occurred since the start of the CI, and the reasons for those changes.

In this case, the information from the initial Context Tool would be brought back automatically, and any changes could be

noted here.


2. Actual start and end dates of CI

3. Did your objectives remain constant throughout the CI?

4. Did you meet your CI objectives? Discuss why or why not.

5. What social determinants of health were addressed through this CI? : (Check as many as appropriate)

Healthy child development

Education

Employment and working conditions

Food security

Health care services

Housing

Income

Social support

Social safety nets and social services

Social justice, equity, human rights

End-of-CI Tool

49

Peace

Stable eco-system, healthy local environment

Other (specify):__________________________________________

End-of-CI Tool

50

6. Main health promotion strategies used/employed : (Check as many as appropriate)

Build healthy public policy

Create supportive environments

Strengthen community actions

Develop personal skills

Reorient health services

Other (specify): __________________________________________

7. Specific activities used in CI

8. Briefly describe how the CI was determined to be “over”.

9. To what extent has this CI led to any other activities (e.g. personal development group, or other CI)? Please list name:

10. What communities/neighbourhoods did the CI work with?

11. Please specify age group(s) of participating population : (Check as many as appropriate)

Age is not a specific characteristic of this CI

0-4 years

5-9

10-14

15-19

20-24

25-29

30-34

35-39

40-44

45-49

50-54

55-59

60-64

65-69

End-of-CI Tool

51

70-74

75-79

80-84

85-89

90+

12. Please select gender of participating population

Gender is not a specific characteristic of this CI

Male

Female

Transgender/transsexual/inter-sexed/questioning

13. Please select primary language(s) of participating population : (Check as many as appropriate)

Language/culture is not a specific characteristic of this CI

English

French

Arabic

Chinese – Cantonese

Chinese – Mandarin

Chinese – Hakka

Chinese – (other)

Cree

Dutch

German

Greek

Hindi

Inuktitut

Italian

Polish

Portuguese

Punjabi

Russian

End-of-CI Tool

52

Somali

Spanish

Tagalog (Philipino)

Tamil

Ukranian

Vietnamese

Other (specify):___________________________________

14. Please select primary description of participating population : (Check as many as appropriate)

Role/status/identity is not a specific characteristic of this CI

Business people

Caregivers

Community leaders

Community members

Community volunteers

Criminal offenders

Employees

Employers

Family members

Gays/lesbians

Health providers

Immigrants

Newcomers

Refugees

Parents

Expectant parents

New parents

Single parents

Persons without a health card

Students

Other (specify): ___________________________________________

End-of-CI Tool

53

15. Please select social/economic conditions addressed by CI : (Check as many as appropriate)

Social/economic condition is not a specific characteristic of this CI

Environmental pollution

Homelessness

Inadequate housing

Language/cultural barrier

Low-income/poverty

Low literacy

Occupational/workplace risks

Racism/discrimination

Social isolation

Underemployment

Unemployment

Violence/abuse

Victims of violence/abuse

Witnesses of violence/abuse

Perpetrators of violence/abuse

Other (specify): ____________________________________________

16. Please select health condition addressed by CI

Health conditions are not a specific characteristic of this CI

Arthritis

Asthma

Diabetes

Hypertension

Heart Disease

HIV/AIDS

STIs

Physical disability

Physical frailty

Obesity

Eating disorder

End-of-CI Tool

54

Chronic pain

Physical fitness

Nutrition

Sexual health

Substance use/addictions

Alcohol

Tobacco

Drugs/medication

Dental health

Mental health

Schizophrenia

Depression

Trauma

Other (specify):__________________________________________

17. Please list CI partners, if relevant

18. Comparing the end-point and beginning-point tool, please describe overall CI progress using the following scale:

Overall ease of CI journey:

Attach summary of any other evaluation

reports that were completed on this CI.

Major hurdles Bumpy road Rough and smooth patches Fairly smooth Smooth sailing

Explain:

55

9. Glossary of Terms

Explanation of Assessment Tool:

Terms:

Indicators: “measurable aspects of a project that can be used to monitor its

progress and direction.9”

Enablers: Events, situations, or contextual factors that positively affect CI

Barriers: Events, situations, or contextual factors that negatively affect CI

Telling the Story: Explaining the process of the CI regarding overall action

area, as deemed relevant by staff

Key Learnings/Best Practice: Points of interest for CI staff (in resident or

other CHC) based on overall action areas

Action Plan: Events, projects, or programs designed to enhance the CI with

respect to the given indicator area

56

References 1. Association of Ontario Health Centres. Briefing note on CIs (unpublished). In; 2008.

2. Goodman RM, Speers MA, McLeroy K, et al. Identifying and defining dimensions of

community capacity to provide a basis for measurement. Health Education & Behavior

1998;25(3):258-78.

3. Kwan B, Frankish CJ, Quantz D, Flores J. A synthesis paper on the conceptualization and

measurement of community capacity. In: University of British Colombia: Institute of Health

Promotion Research; 2003.

4. Rajkumar E. Outcomes of community development in a community health centre setting:

towards an acceptable evaluation framework. In: University of Toronto: Field Inquiry Final

Report; 1997.

5. Public Health Agency of Canada. Community capacity building tool: a tool for planning,

building and reflecting on community capacity in community based health projects. In:

Alberta/Northwest Territories Region, ed.; 2007.

6. Bopp M, Germann K, Bopp J, Littlejohns LB, Smith N. Assessing community capacity for

change: David Thompson Health Centre; 2000.

7. Jackson SF, Cleverly S, Poland B, Burman D, Edwards R, Robertson A. Working with

Toronto neighbourhoods toward developing indicators of community capacity. Health

Promotion International 2003;18(4):339-50.

8. Hawe P, King L, Noort M, Jordens C, Lloyd B. Indicators to help with capacity building

in health promotion. In: New South: New South Wales Health Department; 2000.

9. Duignan P, Casswell S, Howden-Chapman P, et al. Community project indicators

framework (CPIF): its use in community projects; 2003.

10. Arnstein S. A ladder of citizen participation. American Institute of Planners Journal

1969;July:216-24.

11. MacLellan-Wright MF, Anderson D, Barber S, et al. The development of measures of

community capacity for community-based funding programs in Canada. Health Promotion

International 2007;22(4):299-307.

12. Gibbon M, Labonte R, Laverack G. Evaluating community capacity. Health and Social

Care in the Community 2002;10(6):485-91.

13. Association of Ontario Health Centres. AOHC CHIRP: Data collection pilot (v.2 for

review). In; 2007.

57

Appendix: Literature review - Conceptualizing the Domains of Community Capacity

Community capacity: brief description and definition The field of community initiatives has many terms that are not consistently defined. Community capacity was selected as the relevant term of reference due to its mention throughout the rationale for CIs (to strengthen capacity of communities). Several terms are used interchangeably with community capacity; for example community empowerment, community development, and community competence (Kwan et al. 2003). The definition from Kwan et al. (2003) was used in the development of a recent menu of indicators for the AOHC (Wong and Watson 2007). “The characteristics of communities that affect their ability to identify, mobilize, and address social and public health issues of concern”. This definition is also part of a Goodman et al. (1998) definition. Recent work with Toronto communities created the flowing definition: “the potential of a community to build on its strengths in order to work towards and achieve its goals and dreams, given both facilitating and barrier conditions coming from inside and outside the community” (Jackson et al. 2003) A health department (New South Wales Health Department 2001) defines community capacity as: “an approach to the development of sustainable skills, organisational structures, resources and commitment to health improvement in health and other sectors, to prolong and multiply health gains many times over”. Reporting from a CDC conference, Goodman et al. 1998 identify two components of capacity building: “(1) the characteristics of communities that affect their ability to identify, mobilize, and address social and public health problems' [and] (2) the cultivation and use of transferable knowledge, skills, systems, and resources that affect community- and individual-level changes consistent with public health-related goals and objectives.” There are areas of consistency throughout all the definitions, namely: (1) they are not focused solely on the health care sector; (2) skills and strengths are a priority focus; and (3) the role of structures (organizational, external, and internal) is acknowledged. The above definitions demonstrate two components of community capacity; capacity as a process/approach and capacity as a set of characteristics. Community capacity is both, as processes are integral to final outcomes. For the case of the AOHC, any conception of community capacity must acknowledge the role of staff and program processes in long-term work building internal capacity.

58

Domains of community capacity Given the range of definitions of community capacity, there is no consensus on its domains. Furthermore, indicators to measure community capacity are not entirely evidence-based as evidence in the field is still building (Hawe et al. 2000). Table I outlines the variance of main domains from selected sources. These sources were selected if they had developed a list or framework of domains and/or indicators of community capacity. Additionally, each tool had elements that made it a good candidate for inclusion. All sources were recognized in related community development literature as important documents. As explained below, there were various ways to determine domains of community capacity: some sources strictly relied on literature reviews while others created or tested concepts with communities and yet others undertook statistical analysis of their domains.

Description of sources A recent review of reliable, valid, and feasible indicators for use in Ontario’s CHCs notes the dearth of such indicators for community initiatives (Wong and Watson 2007). They refer to PHAC (2007); Kwan et al. (2003); and Hawe et al. (2000) as possible sources for indicators in community capacity, but caution that these indicators should be considered as preliminary as they have not been tested for reliability or validity. While these three sources were in fact tested either via focus groups or surveys with practitioners, literature reviews, and/or statistical analyses, the report authors did not consider this testing to be rigorous enough for inclusion. This restriction hindered development of a comprehensive list of “evidence-based” community capacity indicators in a main list of indicators for all CHCs (Barnsley 2008). Two indicators were related to clinical care and priority health conditions, although these are not mentioned in the other relevant literature. Although limited in scope, the report of Barnsley (2008) is immediately relevant to this draft framework, and, as such, was included. The authors of PHAC (2007) conducted a literature review exploring definitions and understandings of community capacity and tools measuring the term. The team selected nine domains for PHAC-funded programs based on measurability and possibility for timely change and impact on a local level. Indicators for each domain were selected from the literature. These domains and indicators were reviewed by Canadian “experts” in the field of community capacity measurement, who then provided recommendations for a measurement instrument. The instrument was piloted in focus groups with health promotion practitioners and also tested in 29 PHAC-funded community initiatives in central and northern Canada for face validity, construct validity, and internal consistency. The tool uses a “journey” metaphor, with questions for each domain which can be answered on a scale from “just started” to “we’re there.” This tool was selected for its Canadian context, strength of validity and reliability testing, and recent publication. Jackson et al. (2003) used an asset-based framework to conceptualize domains of community capacity within so-called “problem areas” in Toronto. This orientation to research was selected to give voice to the issues deemed important by the community and to develop domains and indicators from community experience

59

rather than related literature. The research team worked in partnership with community groups and conducted key informant interviews, focus groups and semi-structured open-ended interviews. Qualitative results were coded using a coding framework developed by multiple investigators over time. Themes and indicators mentioned in more than one site and with clear measurable aspects were tested and analyzed. Final indicators and domains were shared with members of a community advisory committee. The final conceptualization of community capacity has the talents, strengths, skills, and abilities of the community and its members as a core domain, which is influenced by inside (internal to the community) facilitating/enabling and barrier conditions, which are in turn affected by outside (external to the community) facilitating/enabling and barrier conditions. Indicators are accompanied by possible measurements. This report was selected for its community-grounded development of domains and indicators and presence of a conceptual framework. Gibbon, Labonte, and Laverack (2002) compared nine domains of capacity developed by (Laverack 1999) and eight similar domains developed by (Gibbon 1999). Both studies developed the domains of community capacity from literature review and analysis. Gibbon worked with Nepalese women’s groups to develop indicators for each domain and then to rate them in a group facilitated discussion on a scale from 1 to 4. Laverack used themes and situations from community discussions in Fiji to develop statements ranked from 0(unacceptable) to 4(most satisfactory) for indicators. Having numbers assigned to statements was found to influence the participants’ actions and the numbered scale was subsequently removed. Repeating this process over time provided empirical data, thereby overcoming some of the perceived shortcomings of purely qualitative evaluation. Visual representations (a “spider web” approach) were used by Gibbon at numerous points in order to provide feedback to the community to come to their own evaluation conclusions. This work was selected for its historical significance, as the work of Laverack and Gibbon is consistently cited in relevant literature. Goodman et al. (1998) report on a 1995 symposium at the CDC of community health researchers and community specialists with the aim of identifying domains of community capacity. The starting point for domain selection was an asset-based view of community. Working groups at the symposium identified domains and linkages between domains. The domains are explained in great detail with particular focus on literature. The domains were not determined to be an exhaustive list, but rather a departure point for community-based projects. This work was selected for its strong theoretical basis. Duignan et al. (2003) developed a practical guide for community project planning and evaluation in New Zealand based on existing assessment tools, the authors’ work in community development, and literature of community development, in particular the work of (Laverack and Labonte 2000). Additional domains were added to reflect the importance of inclusion of Maori and Pacific peoples. This work was selected for its recognition of diversity and equity. Hawe et al. (2000) undertook an extensive selection and development of domains and indicators of community capacity in order to improve practice and accountability in the field based on a literature review of capacity building in health promotion,

60

focus groups with urban and rural health promotion workers, and consultations with health and policy workers and managers. Lists of indicators were then provided to program staff who used them in programming and provided feedback on their utility and relevance. The indicators were then tested for reliability and internal consistency, although the authors caution that the indicator testing has not been validated over time, but was rather a static event. The domains are organized into “predisposing factors”, “enabling factors” and “reinforcing factors” and are accompanied by possible sources for information and examples of sub-domains. These sub-domains may be ranked on a scale of 0 (no) to 2 (yes, fully) for quantitative analysis. Domains for organizational capacity and program quality – among others – are also included in the document. This work was selected for the reputation of the authors and the exhaustiveness of selection and description. Bopp et al. (2000) developed a handbook on assessing community capacity based on literature and work history of the authors. Much of the work was based on the Alberta “Heart of the Land” project, for which the authors consulted with community using a participatory action research methodology and then reflected on the results of the literature and consultations in order to develop a framework for assessing community capacity. Rather than set out numerical rankings, the authors instead developed a list of appropriate questions to ask during community initiatives to see if they are on track. This work was selected for its action and community-centred orientation to research and program planning and evaluation. As demonstrated, there are various approaches to the development of domains and indicators of community development. Based on the sources described above, a total of 11 domains were chosen. The following table describes the key concepts related to the domains as derived from these sources.

61

Table I: Domains of Community Capacity

Domain Name PHAC (2007 Gibbon, Labonte, Laverack (2002)

(Jackson et al. 2003) (Goodman et al. 1998)

(Duignan et al. 2003) (Bopp et al. 2000)

(Barnsley 2008) (Hawe et al. 2000)

Participation Participation Participation Participation Citizen participation

Community participation

Participation Participation

Linkages Linking with others

Links with others People come together for a common purpose

Networks and linkages

Collaboration Linkages Collective efficacy, networks

Resources Obtaining resources

Resource mobilization

Resources Increased resources, Project infrastructure and sustainability

Resources, Type/ mix of services

External resource access

Skills, learning, knowledge

Skills, learning, and knowledge

Talents, skills, strengths, abilities

Skills knowledge and skills, On going learning

Leadership Leadership Leadership Leadership Leadership, skills increase

Leadership Representation in decision-making

Community structures/ internal relations

Community structures

Community organizational structures

Internal barriers/facilitators

Enhanced community voices, Conflict managed

Communication Express views, exchange info, Conflict managed

Sense of community and identity

Sense of community

Positive perceptions of community, celebrations

Sense of community, community values, history

Sense of community, shared vision

Commitment to community, community identity

External agents/ community relations

Role of external support

Role of outside agents

External barriers and facilitators

Knowledge of and support for community

Community/external relations

Community control Problem assessment, community program management

Sense of control and ownership over process

Community power Changed organizations

Asking why Asking why Asking why Critical reflection Critical reflection re: project planning

Diversity and equity

Community-supported diversity in projects

Aboriginal and Pacific People’s involvement

Caring for others

62

The above domains/areas for measurement have been grouped into 4 “essential elements of community capacity building (which are the main areas for action and evaluation for CIs). Indicators for each domain will be selected from the literature in conjunction with the development of a tool to evaluate CIs.

Conceptual Framework: Evaluation of Community Initiatives

Essential elements for community capacity building

Domains and areas for measurement

Indicators

Enabling community leadership

Participation * To be determined in conjunction with tool development

Leadership

Community control

Fostering community identity

Diversity and equity


Developing skills and resources

Skills, learning, and knowledge

Resources

Reflection

Building and utilizing structures and relationships

Community and internal structures

External supports and community relations

Linkages

Areas of measurement may be evaluated collaboratively by different stakeholders. In keeping with the values and principles of community capacity building, it is suggested that annual or bi-annual evaluations be conducted jointly by agency staff and community members. Additionally, agency management should be involved in evaluating external supports and community relations; resources; and linkages.

63

The involvement of these key stakeholder groups (agency management, program staff, and community members) in contributing to different parts of the evaluation process is visually represented in the following framework:

Framework: Stakeholder involvement in evaluation process

On-going (brief), funding requirements, demographics

Agency management Program Staff


Community/internal relations

Reflection

Community control

Leadership

Skills, learning, knowledge

External supports and community relations

Resources

Linkages

Participation

Community members

64

Description of domains Based on the review of literature and resources described above, 11 domains for community capacity building were identified, grouped under four “essential elements”.

1. Enabling Community Leadership

Effective Leadership within the community is fostered by participation, and effective leadership is necessary to support broad community participation. Through participation a community is able to influence and determine the processes which shape its health and well-being and, as such, it is a critical component of community control. Participation Participation is the most consistent domain of community capacity. It was widely interpreted to mean multiple stakeholders being meaningfully engaged in various components of projects and programs, including decision-making and evaluation (Bopp et al. 2000; Duignan et al. 2003; Public Health Agency of Canada 2007). Participation is directly related to diversity and equity (ensuring a wide range of actors and community members are involved). Participation is also a critical element of community control, as community members have a direct say in defining, analyzing, and acting on issues of most concern to them (Gibbon, Labonte, and Laverack 2002). This is dependant on the type of participation. For example, if community is involved simply in consultation, this is not as empowering as genuine control over decision making (see for example (Arnstein 1969). Participation is influenced by pre-existing skills, talents, and abilities within a community and a history of community identity (Goodman et al. 1998). It is also enabled by the presence of strong social networks and opportunities for meaningful involvement (Goodman et al. 1998) and, as such, is affected by social and program structures and the organization of programming. Linkages are the mediating factors through which this influence occurs. Another mediating factor is the accessibility of resources to make participation feasible, such as the provision of child care, space for meetings, and compensation for particular activities (Goodman et al. 1998). Participation and leadership are a feedback loop, as strong community leadership is reliant on member participation, community participation can be improved with strong leadership, and participation in multiple aspects of a project may strengthen leadership in a community (Goodman et al. 1998). Leadership Leadership includes both the formal and informal roles of those community members who act to provide direction and vision, engage with others, and enhance project capacity (Goodman et al. 1998; MacLellan-Wright et al. 2007). Leadership and skills, talents, and abilities reinforce each other, as leadership is both dependant on, and a builder of, specific abilities, such as conflict resolution, collaborative work, vision, and decision-making (Duignan et al. 2003; MacLellan-Wright et al. 2007). Leadership and participation are also reinforcing, as mentioned above. Strong leaders can act to

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remove barriers to community participation and act as a pathway through which resources, structures, and programs flow, and ensure that networks are strengthened within community and between community and external factors (Goodman et al. 1998; Gibbon, Labonte, and Laverack 2002).These connections and opportunities guide overall learning and skill development (Bopp et al. 2000). Community Control Community control, in keeping with Gibbon, Labonte, and Laverack’s (2002) vision of empowerment presumes that: “the identification of problems, solutions to the problems and actions to resolve the problems are carried out by the community.” Goodman et al. (1998) refer to community power: the ability of a community to have influence and create or resist change (with partners) in matters relevant to the community while (Jackson et al. 2003) emphasize “community members hav[ing] a sense of control and a sense of ownership in relation to planning and implementing local programmes and activities.” Community control links through virtually all domains of community capacity, as informal leadership, a base of power and participation are increased with community control. Correspondingly, resources such as internal linkages and external political capital may increase in communities who both cultivate these resources and linkages and ensure that the environment is conducive to their development (Goodman et al. 1998).

2. Fostering Community Identity

A sense of community identity is expressed in terms of determining who is/isn’t involved and how members conceptualize their membership and their place within the community. Communities are diverse and, as everywhere, inequities are real and present. Sense of Community and Identity A sense of community is characterized by members feeling connected to each other and the space they inhabit, overall levels of respect and concern for each other and for larger issues affecting the community, and a positive perception of the community (Bopp et al. 2000; Goodman et al. 1998; Jackson et al. 2003; Hawe et al. 2000). This is fostered through on-going participation in community structures and linkages (MacLellan-Wright et al. 2007; Hawe et al. 2000). Reflection and sense of community are interlinked, as group reflection on community circumstances can lead to increased awareness of the issues faced by all and their place within a larger context. In turn, this can affect external agents in issue definition for projects, particularly if the community is involved in the process (MacLellan-Wright et al. 2007; Goodman et al. 1998). Desire of community members to lead and participate within activities and to build networks is fostered by a strong sense of community (Goodman et al. 1998). With a strong sense of community identity, power may be more equally or equitably distributed, therefore influencing the diversity of voices heard in processes (Goodman et al. 1998). Diversity and equity

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The concept of diversity and equity is not always delineated as a separate domain in community capacity, but is often mentioned in reference to participation and community/internal relations. In the case of (Duignan et al. 2003), diversity is an explicit domain due to the authors’ location in New Zealand, where Maori treaty rights guide community involvement in relevant projects. This orientation has been extended to other Pacific peoples as well. Jackson et al. (2003) emphasize that community-supported diversity in projects should be considered an indicator of capacity and Hawe et al. (2000) describe mutual caring for all members of and issues in a community as a predisposing factor for community capacity.

3. Developing Skills and Resources

Community capacity is often defined in terms of its characteristics, such as increased skills of community members, stronger linkages within and without community, and increased access to community and external resources. Reflection is both a skill and a resource in that it is a process that should help communities uncover the root causes of issues they face and plan for action accordingly. Resources Resources for community capacity include time, funding, personnel and/or volunteer support, information, and facilities. The ability of a community to mobilize these resources is a key factor in long-term community success (Gibbon, Labonte, and Laverack 2002). Necessary and valuable resources exist both within and outside of communities (MacLellan-Wright et al. 2007; Goodman et al. 1998; Hawe et al. 2000; Duignan et al. 2003). Increasing resources does not necessarily lead to increased community capacity, but it is an enabling factor, as it creates the space and opportunities for participation and involvement from diverse groups (Duignan et al. 2003; Goodman et al. 1998). The distribution of resources within a community will be affected by the diversity and equity represented in community structures and can in turn reinforce or transform this representation (Bopp et al. 2000). As well, the influence from programs, organization, external agents, and larger structures on community-level factors often works through the resources made available from these linkages, such as community health workers, education programs and funding for meetings and activities (Goodman et al. 1998). Skills, learning, knowledge Skills, talents, and abilities in place in a given community are present on both the individual (e.g. the ability to chair a meeting) and community level (e.g. ability to work together and resolve conflict) (Jackson et al. 2003; Goodman et al. 1998). As starting points, goals, and facilitating factors, these form the bedrock of community capacity building (Jackson et al. 2003; MacLellan-Wright et al. 2007). Leaders need particular skills, such as decision-making, networking, and mentorship for further leadership, linkages connect complementary and necessary skills, advocacy and action need particular skills such as group organizing, and critical reflection is a skill that facilitates learning (Goodman et al. 1998). Learning for community capacity is a long-term, ongoing process that is inextricably connected to reflection and “asking why” in the community and external organizations (Bopp et al. 2000). Reflection

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“Asking why” is a community process where the root – or upstream - causes of an issue are analyzed with a problem-solving focus. Community control is fostered as a community better understands the base causes of issues and develops change strategies and programming alongside external partners (Gibbon, Labonte, and Laverack 2002; MacLellan-Wright et al. 2007; Duignan et al. 2003). Given that many of the upstream determinants of community health are rooted in external and internal structures (including barriers to access, discrimination, inequity, education opportunities, etc)(Jackson et al. 2003), there are implicit connections between reflection and all domains of community capacity. Furthermore, as this process uncovers issues through community processes, sense of identity and meaning may be influenced (Goodman et al. 1998).

4. Building and Utilizing Structures and Relationships

Strong structures and relationships within a community, and between the community and external organizations, provide the necessary foundations for community capacity through linkages and access to resources. The values and principles of programming and staff influence the processes and outcomes of community initiatives. Community structures/Internal Relations Just as there are previously existing skills, abilities, and talents within communities, there are also structures such as organizations, networks, and groups (MacLellan-Wright et al. 2007; Gibbon, Labonte, and Laverack 2002). These structures and relations can both enable and hinder community capacity (Jackson et al. 2003). Strong structures and enabling internal relations ensure that a diverse range of voices are heard and acted upon, affecting participation (Duignan et al. 2003; Bopp et al. 2000). Leadership is also a component of community structures, given that leaders both operate in, and shape, their environments (Goodman et al. 1998). Strong community structures facilitate work with external agencies and structures and may help develop a sense of, and commitment to, a community by its members (Hawe et al. 2000). Structures are essential for community control, as they form a base point for reflection and action (Gibbon, Labonte, and Laverack 2002). External agents/community relations External agents include funders, agencies, and health centres external to the community as well as policies and perceptions (Jackson et al. 2003). Outside agents have a strong role to play in fostering community capacity by challenging external barriers to development such as detrimental policy and negative perceptions within other external agencies (Jackson et al. 2003). These organizations may also provide communities with resources or links to appropriate sources for collaborative action (MacLellan-Wright et al. 2007; Gibbon, Labonte, and Laverack 2002). A strong relationship between community and external relations is critical to long-term sustainability in capacity building, as learnings can be shared across communities and agencies (Hawe et al. 2000).

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Linkages Linkages and collaboration with other agencies, communities, networks, organizations, or individuals are considered essential for strong community capacity (MacLellan-Wright et al. 2007). These connections foster access to a range of resources (MacLellan-Wright et al. 2007; Goodman et al. 1998; Hawe et al. 2000), increase opportunities for collective learning action across sectors and groups (MacLellan-Wright et al. 2007; Duignan et al. 2003) and can increase representation and participation of diverse groups (MacLellan-Wright et al. 2007; Hawe et al. 2000). Networks also bring complementary skills together, creating a whole that is greater than the sum of its parts (Goodman et al. 1998; Duignan et al. 2003). Community identity and a sense of community are strengthened through linkages and collaboration where trust and cooperation is developed (when linkages work beneficially) (Goodman et al. 1998). Increased skills, resources, and sense of community foster an environment conducive to increased community power as well as multiple avenues through which community members may act (Goodman et al. 1998). Of course, the development of strong linkages is dependant on resources, skills, participation and pre-existing organizations and programs (Duignan et al. 2003).

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